Sign in →

Test Code CRBFT Carbamazepine, Free and Total, Serum

Reporting Name

Carbamazepine, Free and Total, S

Useful For

Monitoring carbamazepine (free and total) therapy in uremic patients

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum Red


Shipping Instructions


 



Specimen Required


Container/Tube: Red top

Specimen Volume: 2 mL

Collection Instructions: Tubes should be centrifuged and aliquoted within 2 hours of collection.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 7 days
  Frozen  28 days
  Ambient  48 hours

Reference Values

CARBAMAZEPINE, TOTAL

Therapeutic: 4.0-12.0 mcg/mL

Critical value: ≥15.0 mcg/mL

 

CARBAMAZEPINE, FREE

Therapeutic: 1.0-3.0 mcg/mL

Critical value: ≥4.0 mcg/mL

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

80156-Carbamazepine, Total, S

80157-Carbamazepine, Free, S

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CARFT Carbamazepine, Free and Total, S 34545-4

 

Result ID Test Result Name Result LOINC Value
CARF Carbamazepine, Free, S 3433-0
CARTA Carbamazepine, Tot, S 3432-2

Clinical Reference

1. Svinarov DA, Pippenger CE: Relationships between carbamazepine-diol, carbamazepine-epoxide, and carbamazepine total and free steady-state concentrations in epileptic patients: the influence of age, sex, and comedication. Ther Drug Monit 1996;18:660-665

2. Bernus I, Dickinson RG, Hooper WD, Eadie MJ: The mechanism of the carbamazepine-valproate interactions in humans. Br J Clin Phamacol 1997;44:21-27

3. Dasgupta A, Volk A: Displacement of valproic acid and carbamazepine from protein binding in normal and uremic sera by tolmetin, ibuprofen, and naproxen: presence of inhibitor in uremic serum that blocks valproic acid-naproxen interactions. Ther Drug Monit 1996;18:284-287

4. Moyer TP: Therapeutic drug monitoring. In Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, ER Ashwood. Fourth edition. Philadelphia, PA. WB Saunders Company 2005 pp 1237-1285

5. Patsalos PN, Berry DJ, Bourgeois BF, et al: Antiepileptic drugs-best practice guidelines for therapeutic drug monitoring: A position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia 2008;49(7):1239-1276

Method Description

Carbamazepine:

The ONLINE TDM Carbamazepine Gen.4 assay is a homogeneous microparticle agglutination immunoassay. It is a 2-reagent system used for the detection of carbamazepine in serum. Kinetic interaction of microparticles (KIMS) will be measured using automated analyzers. In this technology biotinylated drug hapten attached to streptavidin coated latex beads serves as the binding partner to anticarbamazepine antibody. A competitive reaction to a limited amount of specific anticarbamazepine antibody takes place between the latex bound hapten and free carbamazepine in the serum sample. A decrease in the apparent signal is proportional to the amount of drug present in the sample.(Package insert: Roche Carbamazepine reagent, Roche Diagnostic Corp, Indianapolis, IN 2016-04)

 

Free Carbamazepine:

Free carbamazepine is isolated from serum by ultrafiltration. The ONLINE TDM Carbamazepine Gen.4 assay is a homogeneous microparticle agglutination immunoassay. It is a 2-reagent system used for the detection of carbamazepine in serum. Kinetic interaction of microparticles (KIMS) will be measured using automated analyzers. In this technology biotinylated drug hapten attached to streptavidin coated latex beads serves as the binding partner to anticarbamazepine antibody. A competitive reaction to a limited amount of specific anticarbamazepine antibody takes place between the latex bound hapten and free carbamazepine in the serum sample. A decrease in the apparent signal is proportional to the amount of drug present in the sample.(Package insert: Roche Carbamazepine reagent, Roche Diagnostic Corp, Indianapolis, IN)

Analytic Time

Same day/1 day

Reject Due To

Gross hemolysis Reject

Method Name

CARF: Ultrafiltration Followed by Homogeneous Microparticle Agglutination Immunoassay

CARTA: Homogeneous Microparticle Agglutination Immunoassay

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Profile Information

Test ID Reporting Name Available Separately Always Performed
CARTA Carbamazepine, Tot, S Yes Yes
CARF Carbamazepine, Free, S Yes Yes